Microdermabrasion device

ABSTRACT

A treatment tool and tissue collection system, for removal of outer layers of skin to provide a revitalized, fresh skin surface, and a method of using same, comprising a abrasive tipped tool mounted on the end or within the end of a hollow tube, said tube being connected to a source of vacuum. The vacuum aids in maintaining intimate contact between the abrasive tip and the skin during the treatment process and transports the removed tissue to a collection container. The abrasive surface within the tube is a motor driven abrasive pad. Contact between the pad and the abrasive disk is brought about or increased by application of a vacuum through the tube to the skin surface.

This application is a National Stage Application filed under 35 USC §371claiming benefit of PCT/US00/42049 filed Nov. 9, 2000, which wasdesignated as a CIP of U.S. application Ser. No. 09/440,020 filed Nov.12, 1999, now U.S. Pat. No. 6,241,739 issued Jun. 5, 2001.

BACKGROUND OF THE INVENTION

This invention provides a treatment tool and tissue collection systemfor remove of outer layers of skin to provide a revitalized, fresh skinsurface. This objective is to remove dead and old skin cells withoutdamaging the remaining skin surface and without the use of powderedabrasive materials because these materials may result in undesirableside effects.

DESCRIPTION OF THE PRIOR ART

Dermabrasion, also referred to as microdermabrasion, is a process forremoval of dead cells from the outermost layer of the skin, referred toas the epidermis, clean out blocked pores, and enhance skin tone.Additionally, the margins of acne scars and other traumatic scars can beerased and aging spots and sun damaged skin can be polish off. Stillfurther, charred tissue, following a burn injury must be removed toenhance healing of the underlying tissue. This must be accomplishedwithout injuring the lower two layers, namely, the dermis and thesubcutaneous layer or lower dermis. Typically, the skin surface istreated a minimum of 5 times spaced 7 to 10 days apart. This is thenfollowed by periodic maintenance sessions. The benefits are:

-   -   1. poor, dull skin is enhanced by a gentle resurfacing of the        superficial skin layers,    -   2. expression lines typically seen on the forehead and around        the mouth are softened,    -   3. fine, crepey lines on the cheeks, generally caused by aging        and sun damage are reduced,    -   4. pigment changes and skin discoloration are reduced,    -   5. enlarged pores are reduced and clogged pores typical in acne        conditions are exfoliated and cleaned out, and    -   6. margins of superficial acne marks, stretch marks, burn scars        and surgical scars can be smoothed.

Use of abrasion techniques can be traced back to the ancient Egyptianswho used alabaster and pumice to remove blemishes and rough spots and tomake the skin smooth and soft. More recently, abrasive tipped devices orrotating brushes and cylinders coated with abrasive particles, such asdiamond dust, have been used to remove skin layers (U.S. Pat. No.2,712,823; U.S. Pat. No. 2,867,214; U.S. Pat. No. 2,881,763; U.S. Pat.No. 2,921,585). U.S. Pat. No. 5,800,446 describes a stick, glove fingertip or glove palm coated with an abrasive material which is rubbed overthe skin surface to provide a polishing action. U.S. Pat. No. 3,964,212directed to a pneumatic grinding machine for flat surfaces, incorporatesa rotating grinding tool enclosed in a housing with air flowing over thesurface to collect dust created by the grinding operation. U.S. Pat. No.4,378,804 is directed to a skin abrasion device which uses flowing waterto rotate an abrasive brush and create a vacuum to remove loosened skinparticles. The rotating brush is usually used in conjunction with aliquid detergent or medicinal compound applied to the skin surface beingscrubbed. Chemicals, ultrasonic oscillating tips (U.S. Pat. No.5,012,797) and lasers have also been used for a more aggressiveabrasion. U.S. Pat. No. 5,037,431 describes the use of a pressurized jetof a liquid, such as water or sterile saline, to fragment and removediseased tissue without harming surrounding healthy tissue. This deviceoperates in conjunction with vacuum aspiration to remove the liquid andfragmented tissue.

The present trend is to abrade the skin surface using powdered aluminumoxide or a liquid topical composition containing suspended aluminumoxide (U.S. Pat. No. 4,957,747). U.S. Pat. No. 5,037,432 provides forthe pressurized delivery, using compressed air, of a powdered, abrasivesubstance and the removal of the abrasive substance and loosened skintissue using a vacuum. The abrasive substance is typically microcrystalsof quartz, metal, or aluminum oxide. The powdered abrasive is blownthrough a wand which has a hole in the skin contact end to provideaccess of the abrasive to the skin surface being treated. An alternativeis to cause the aluminum oxide powders to flow by applying a vacuum tothe exhaust side of a container holding the abrasive powder andentraining the powder in a flowing gas stream. The powder is then drawnby the vacuum through a treatment tool, across the skin surface toabrade or rub off the epidermis and then recovered along with the skinparticles in a collection chamber (U.S. Pat. No. 5,100,412; U.S. Pat.No. 5,207,234; U.S. Pat. No. 5,810,842). This process is similar to“bead-blasting”. A potential disadvantage of all of these techniques isthat particles can be lodged in the skin and a substantial amount ofaluminum oxide and cells, which have to be properly disposed of, may beleft behind on or in the skin.

While no toxic effects have been shown from aluminum oxide left on or inthe skin, this material has been shown to cause inflammatory changes tothe lungs in workers who have inhaled aluminum oxide. ( Schwarz, Y, etal., “Evaluation of Workers Exposed to Dust Containing Hard Metals andAluminum Oxide” Am J of Ind Med, 34(20; 177-82) 1999 Aug.). Also, theeyes must be protected from the highly abrasive dust, which can injurethe cornea. Therefore, it is recommended that workers using thesedevices wear breathing masks and glasses to provide protection fromophthalmic and respiratory damage. Similar protection is suggested forpatients being treated. It is also possible that particles of theabrasive material can be left imbedded in the skin surface resulting inlong term irritation and provide a situs for bacterial infections.

SUMMARY OF THE INVENTION

The device for microdermabrasion comprises a hollow tube with andabrasive material permanent attached to a skin contacting end. Theabrasive coated tip is moved over the skin surface while a vacuum isapplied through the tube to the skin surface to remove cells abradedfrom the skin surface. The vacuum also causes the skin to be held inintimate contact with the abrasive tip during the treatment procedure.

DESCRIPTION OF THE FIGURES

FIG. 1 is a schematic drawing of a device incorporating features of theinvention.

FIG. 2 is a partial cutaway view of a treatment tube and filter assemblyused in the device of FIG. 1.

FIG. 3 is a schematic drawing of the vacuum flow path of the device ofFIG. 1.

FIG. 4 is a cutaway side view of the end of the treatment tube.

FIG. 5 is an enlarged view of the circled portion of FIG. 4.

FIGS. 6 and 7, are cutaway side views of two different treatment tubesusable with the device of FIG. 1.

FIGS. 8 and 9 are end views of the two different treatment tubes ofFIGS. 6 and 7, respectively

FIG. 10 is a cutaway side view of the end of a sloped treatment tube.

FIG. 11 is a cutaway side view of the end of a tapered treatment tube.

FIG. 12 is a cutaway side view of a valved treatment tube.

FIG. 13 is a cutaway side view of the end of a treatment tube with asecond tube for delivery of a supplemental treatment fluid.

FIG. 14 is a side cutaway side view of the end of a treatment tube withan enlarged, sloped end.

FIG. 15 is an end view of the treatment tube of FIG. 14.

FIG. 16 is a side cutaway side view of the end of a treatment tube withan enlarged, sloped concave end.

FIG. 17 is a view of a rectangular shaped treatment surface with thehandle being the conduit for the vacuum.

FIG. 18 is a cutaway side view of the end of a treatment tube with anenlarged, rectangular shaped end.

FIG. 19 is schematic perspective view of a further version of a deviceincorporating features of the invention incorporating a rotatingabrasion piece.

FIG. 20 is cutaway side view of a hand piece for use with the device ofFIG. 19.

FIG. 21 is an enlarged cutaway view of the circle portion of FIG. 20.

DETAILED DESCRIPTION OF THE INVENTION

The invention provides the capability to perform microdermabrasionwithout the potential health risks or hazards of using a flowing,powdered metallic substance such as aluminum oxide. This is generallyaccomplished by the use of a tube having a treatment tip with anabrasive material permanently attached thereto. The term “tube” or“tubular” used herein refers to an elongated hollow structure of anycross section, which includes, but is not limited to, a round, oval,square or rectangle cross section. The abrasive coated end piece, whichmay also have various different shaped cross sections, may be secured tothe treatment tip or be removable and interchangeable. The abrasive tipis rubbed over the skin surface being treated. The tube and relatedinstrumentation also provides a vacuum collection and an optional filtersystem for collection of the skin cells removed by the procedure, theskin cells being aspirated through a hole or holes in the centralportion of the abrasive tip. The vacuum also aids in making an intimatecontact between the skin and the abrasive coated tip.

FIG. 1 shows the overall system which comprises a housing 10 whichencloses a vacuum pump 24, an ON/OFF switch 12, a gauge 14 to measurethe level of vacuum and a valve 16 to adjust the vacuum. While notnecessary for operation of the invention, shown mounted on the externalsurface of the housing 10 is a filter assembly 18. Attached to thefilter assembly 18 is a hollow tube or wand assembly 20 upon which thetreatment tip 22 is mounted. The other end of the filter assembly 18 isconnected to the vacuum pump 24 located inside the housing 10.

FIG. 2 shows the wand assembly 20 comprising tubing 26 connecting thetip 22 and filter assemble 18. Within the filter assembly 18 is a filterpad 28 which collects the loosened skin tissue and prevents the skintissue or collected body fluids and oils from entering the vacuum pump.The various different tips 22 are discussed in detail herein below. Thetubing 26 is flexible so that it is easy to manipulate the tip and toallow ready connection of the wand assembly 20 to an upper hollowextension 30 on the external surface of the filter assembly 18 and aconnector tube 32 on the tip. Since the system uses vacuum, theconnections are self-sealing.

A lower hollow extension 34 extending from the filter assembly 18 fitsinto a matching hole on the main housing. 10. The filter assembly 18 iseasily removable so that it can be replaced after each patient anddisposed of. The filtration pad 28 inside the filter housing 18 catchesthe debris but allows air to easily flow through the pad. The lowerhollow extension 34 allows air pulled through the filter assembly 18 tobe drawn into the vacuum pump 24.

FIG. 3 shows the flow of the air stream through the vacuum system. Itcomprising a vacuum pump 24, filter assembly 18, tubing 26 whichconnects the filter to the treatment tip 22 and vacuum line 36connecting the filter assembly 18 to the vacuum pump 24. The vacuum pump24 is operated at a fixed speed to produce a fixed vacuum level. Tocontrol the level of vacuum applied through the treatment tip 22 to theskin, a valve 16 vents air into the system, thus reducing the amount ofvacuum. Gauge 14 allows the level of vacuum to be monitored. Of course,the vacuum pump can be operated at different speeds to change the levelof vacuum applied.

Referring to FIG. 2, a vacuum is applied through the tube 26 to a hole38 in the treatment tip 22. The tip 22 is brought into contact withskin, the vacuum causing the skin to be pressed against a roughenedsurface on the end 40 of the treatment tip. As the tube is manuallymoved across skin the roughened surface abrades the epidermis dislodgingcells from the surface. The vacuum causes the dislodged cells to flowinto the wand assembly 32. The level of abrasion depends on the level ofvacuum applied to the treatment tip and the size of the abrasiveparticles attached to the treatment tip.

FIG. 4 is a side view of the working end of the treatment tip 22. Theend of the treatment tube 22 has diamond grit 42 preferably adhered tothe end of a metal tube by a plating process using nickel 44 as abinder. The nickel 44 is applied in a controlled manner so thatsufficient nickel is present to hold each piece of diamond in place, butyet allow a faceted portion of the diamond to be exposed, the sharpedges of the diamond providing the cutting edges. A diamond particlesize of around 0.0035 inches (63-75 microns) produces a smooth anduniform removal of skin surface. However, diamond particles from about50 to about 150 microns can be used to produce different levels ofabrasion, the larger particles removing more skin cells and performingthe cell removal more rapidly. However, if the particles are to largethe dermis can be damaged and injury to the second and third layers ofskin can occur. Very fine particles remove few skin cells and act morein a polishing manner. Other abrasive materials, such as aluminum oxide,can be bonded to the treating tool tip or the tip itself can have aroughened surface cut into the end thereof Use of all adhered aluminumoxide of about 100 grit (151 μ) provides a coarse (aggressive)treatment, and use of about a 120 grit (127 μ) material provides amedium level of treatment. Particles with a higher grit (i.e. small sizeparticles) would create more of a polishing effect. Of course, manydifferent hard abrasive materials known to those skilled in the art,such as silicon carbide, silicon oxide, and various metal nitrates canbe used in place of the diamond or aluminum oxide.

The dimensions and materials used to construct the wand assembly 20 arenot critical. However, a preferred treatment tip 22 is formed from a 12mm OD stainless steel tube with a 6 mm ID and a diamond coated end. Thestainless steel/diamond tool can be steam or chemical sterilized betweenuses without damage. A first alternative would be to have a single useor single patient tube, which is made of plastic, the end being coatedwith aluminum oxide, or similar abrasive materials. The abrasive canalso be adhered with an adhesive. A further alternative would be a tube,which could be stainless steel, plastic or other stiff tubular material,with a suitable removable and replaceable tip or a tip with an abrasiveend surface formed by a machining process.

FIGS. 6 and 8 show a removable disc 46 sized to fit over the end 40 ofthe tube 22. The disc 46 has an abrasive end or abrasive materialattached to the outer end. During the procedure various disc withdifferent abrasive characteristics can be interchanged and at theconclusion of the procedure the disc(s) 46 can be discarded.

The end of the tube can also be made abrasive by machining the surfaceas shown in FIGS. 7 and 9 in a manner commonly called knurling. Diamondshaped projections 48 are raised on the surface for abrading in anydirection. This would be similar to the construction of wood and metalfiles. The tip as shown in FIG. 9 can also be provided which raisedportions tapered and oriented in only one direction, similar to a sawteeth, except the tooth would only be a few thousands of an inch high,to achieve smooth abrading of the surface.

Besides providing different means of abrasion on the end of thetreatment tip 22, the contour or shape of the tip can be varied. FIGS. 6and 7 show a flat end. The flat end can provide a greater surface areain contact with the skin for an aggressive removal of surface cells. Aconcave surface as shown in FIG. 4, in conjunction with the vacuumapplied to the skin surface results in a more uniform cutting surface onthe skin. For easier access to difficult to reach locations theroughened ends can be sloped, as shown in FIG. 10, or tapered, roundedor cone shaped, as shown in FIG. 11, to better treat curved surfaces,such as the area between the cheek and the nose.

The device uses a vacuum pump 24 which generates a constant level ofvacuum, which is controlled (lessened) by the venting of air into thesystem by the valve 16 mounted in the housing 10. As an alternative, thefull vacuum can be applied to the wand assembly 20. The level of vacuumcan then be decreased by air vented into the system through vent hole 50by adjusting flow control valve 52 mounted on the wand 22 or treatmenttube 20, as shown in FIG. 12. The valve 52 can be configured to be asimple on/off control or variable so that suction can be readilyadjusted by the operator while performing the procedure.

While the treatment tube can be used alone to abrade the skin and thevacuum system can be configured to primarily pick up the loosened skincells, it has been found that applying the vacuum through the hole 38 inthe end of the treatment tip 40 provides an unexpected advantage. Theskin being treated is pulled against the abrasive tip, thus increasingthe effectiveness of the tissue abrasion and removal process. Sealingoff ambient air raises the level of vacuum and makes the abrasion moreaggressive. The concave tip as shown in FIG. 4 is particularly effectivewhen used in conjunction with a vacuum, as it provides a larger surfacearea for the skin/abrasive material contact.

As a further variation, the treatment tip 22 can have an enlargedabrasive coated end 56, 58 which is flat and slopped or sloped andconcave such as shown in FIGS. 14 and 16 respectively. While a singlehole 38 in the center of the end 56 may be used for applying the vacuum,the efficacy of the abrasive tip can be improved by using several holes38 therein FIG. 15 is an end view showing an example of a flat, slopedabrasive tip with multiple openings for application of the vacuum to theskin surface. An end view of the concave tip of FIG. 16 would have asimilar appearance. Further, while FIGS. 14 and 16 show the end to bepart of the treatment tip 22 it could be a separate removable piece asshown in FIGS. 6 and 8. These configurations have particular utility intreating large flat body surfaces such as the chest, back and legs of anindividual. They can also be used where a large abrasive treatmentsurface is desired but it is preferential to spread out the appliedvacuum so that it does not aggressively suck skin into the tip or suckthe skin into the tip at a single point.

FIG. 13 shows a second tube 54 mounted on the treatment tip 22. The tubecould be used to allow the metered use of chemicals to enhance theabrasion or supply or other liquids to reduce friction.

To use devices embodying the invention the vacuum is applied, throughthe treatment tool, to the area of the skin to be treated while theabrasive surface, which surrounds the applied vacuum, is moved over theskin surface to be treated. The abrasive tip is typically moved over theskin surface in a circular motion. However, a combination of verticaland horizontal movements of the tip, with or without the circularmovements, may also be used to assure that the skin area is uniformlytreated. Also, if a particular skin blemish or abnormality is to betreated. The tip motion can be restricted to that particular portion ofthe skin.

FIGS. 17 and 18 show an elongated treatment end with a large centralopening 59 for application of the vacuum to the skin. In this case, thedevice has wide treatment, shaded like a razor, and elongated abrasiveareas for debrading flat areas of skin.

The further embodiment shown in FIGS. 19-21, while useful for generalskin abrasion procedures discussed above, has particular utility wherepatients have serious bums and must have the dead skin and charredtissue removed. Removing this tissue quickly after the bum can reducethe possibility of infection since the dead tissue is a location whereharmful bacteria can hide.

Presently, devices to remove this dead and charred tissue are calleddiamond fraises. Fraises are cylinders coated with diamond abrasivewhich are rotated with an electric motor. These are essentiallyhigh-speed, hand-held grinders. The procedure is messy even though thereare guards which are suppose to reduce the spray generated. Besides themess and potential medical risk to medical practitioners performing theabrasion, it is very difficult to uniformly remove the desired tissue.

An additional use of this embodiment is to reduce major scars. Thesescars can be caused by severe acne, where the skin is heavily indented,or in the case of trauma, the scar may protrude above the skin surface.

A device which can uniformly remove both the charred material resultingfrom bums and reduce trauma scaring is shown in FIGS. 19-21.

FIG. 19 shows a block diagram of the system comprising a console 110which houses a power on-off switch 109, a vacuum pump 111, a gauge 112to display the vacuum pressure, a control valve 113 with knob to adjustthe vacuum pressure, an electronic control 114 to power the hand piecemotor 115 and a cord 116 which connects the hand piece 150 to the motorcontrol. A canister 118 is used to separate the tissue and fluids fromthe vacuum air while a container 119 holds sterile fluids to irrigatethe diamond disc 130 and the area of the skin being abraded.

The hand piece 150 is constructed as shown in FIG. 20. Within the handpiece 150 is a rotating abrader 132 which is removable for cleaning. Anabrasive coating 130 working end of the rotating abrader 132 is used toabrade the skin surface 131. Rotation of the abrader 132 is provided byelectric motor 133 which is activated by the on/off control 117 mountedon the hand piece. An alternative is to use a foot pedal (not shown) toturn the motor on and off. Tubing 134 provides fluid for irrigation.This fluid also acts as a coolant and aides in removing the loosenedskin and char particles. Tubing 135 is a conduit for providing a vacuumforce to the abrasion site, the opposite end being connected to theparticle collection system 118 and vacuum source 111. The vacuum ismaintained in the hand piece 150 tip by vacuum seal 136. This seal alsokeeps fluids out of the motor portion of the handpiece. The componentsof the handpiece are enclosed within housing 137, the open end 152 ofwhich contacts the skin and creates a chamber for the vacuum. Thehousing 137 may be constructed of a clear plastic for visibility,structural plastics or any of numerous metals, such as stainless steelor aluminum, frequently used for medical instruments and which can beeasily cleaned and sterilized.

As indicated above, the console 110 houses the vacuum pump 111, thevacuum gauge 112 and the control valve 113. The adjustable vacuum isused to provide a negative pressure between the skin surface 131 and theabrasive 130 on the rotating disc 132. The vacuum also sweeps away thedebris and irrigation fluid. The fluid and debris is separated from theair by a filter in the collection system 118. Irrigation fluid,contained in a sterile reservoir 119, is supplied to the abradingsurface by the tube 138.

To operate the system, the vacuum is set to a low pressure (for example10 in-hg) and the motor speed is set to the desired speed (for example15,000 RPM). The open end of the hand piece 150 is placed against theskin surface 131. The vacuum causes the skin to bulge slightly and besucked into the open tip 152 of the hand piece 150, bringing it intocontact with the abrasive surface. The reduced (negative) pressure alsocauses the irrigation fluid to flow into the hand piece, thuslubricating and cooling the surface to be abraded. The on-off button 117is depressed starting the motor. The hand piece is then moved along thesurface, abrading and removing the tissue that comes into contact withthe abrasive surface. The debris flows through the vacuum tubing 139 andinto the collection chamber/filter 118.

As indicated above, the abrasive surface can be provided in many ways,such as by a diamond coating, machined surface, or even a raise surfacesuch as in a common cheese grater.

Also, the size can be varied from a large abrasive surface for burns toa pencil point abrader for small surgical scars.

While the invention has been shown and described with reference todifferent embodiments thereof, it will be appreciated by those skilledin the art that variations in form, detail, compositions and operationmay be made without departing from the spirit and scope of the inventionas defined by the accompanying claims.

For example, the vacuum does not have to be provided by a vacuum pumpwith controller housing but can be provided by a centrally locatedvacuum system such as may be available in a hospital or medicalfacility. However, to prevent contamination of the vacuum system thefilter assembly should be provided to collect the tissue removed. Theabrasive tip has been described as formed by adhering or attaching anabrasive material thereto or machining the surface of the tip to createa roughened surface. However, one skilled in the art will recognize thatthere are numerous chemical and mechanical processes to create aroughened surface on the end of the treatment tip sufficient forperforming the process described herein.

1. A microdermabrasion device for removing portions of the outer layersof a skin surface comprising: a source of a vacuum, and a tube with anabrasive treatment tip therein for dislodging cells from the skinsurface being treated, the tube being attached to the source of vacuumso that a lumen through the tube has a reduced pressure therein which isless than the ambient pressure surrounding the tube, the tube having afirst end, said first end having an opening therein for applying thereduced pressure within the tube to the skin surface, said vacuumcausing the skin surface being treated to have an increased area ofcontact with the abrasive tip, the vacuum also functioning to collecttissue or cells removed from the skin surface being treated wherein theabrasive treatment tip is a rotatable an abrasive pad located within andthe tube adjacent to the opening of the first end configured to rotateat least 360° within the tube, and a collection filter disposed betweenthe treatment tip and the source of vacuum so that all particulatematter entering the at least one opening in the tube is collectedtherein.
 2. The device of claim 1 wherein the source of vacuum is avacuum pump enclosed within a housing, the housing have having meansthereon for monitoring and controlling the level of vacuum delivered. 3.The device of claim 1 further including means for varying the level ofreduced pressure applied through the treatment tip.
 4. The device ofclaim 3 wherein the means for varying the level of reduced pressureapplied through the treatment tip is a valve mechanism mounted in thetreatment tube.
 5. The device of claim 3 wherein the means for varyingthe level of reduced pressure applied through the treatment tip is avalve mechanism in operative connection to the source of vacuum.
 6. Thedevice of claim 1 wherein the abrasive tip has diamond, aluminum oxide,silicone carbide, silicon oxide or metal nitride particles attachedthereto.
 7. The device of claim 1 wherein the abrasive tip has amechanically or chemically created roughened surface.
 8. The device ofclaim 1 further including a collection filter disposed between thetreatment tip and the source of vacuum so that all particulate matterentering the at least one opening in the tube is collected therein.
 9. Amicrodermabrasion device for performing micro-abrasion of a skin surfacecomprising a tubular device with a lumen there through, the tubulardevice having a first end with a rotatable abrasive tip having anabrasive surface, the abrasive tip mounted on a multiple RPM drive toprovide rotary motion, the first end having an opening therein, therotatable tip positioned inside the lumen and adjacent the opening, andmeans on a second end thereof for attachment to a source of a vacuum toapply a negative pressure to a surface to be treated, said vacuumcausing increased contacted contact between the skin surface and theabrasive surface, and a collection filter disposed between the first endand the source of vacuum so that all particulate matter entering theopening in the tube is collected therein.
 10. The tubular device ofclaim 9 wherein the abrasive surface on the tip comprises crystallinediamond pieces permanently secured to said tip.
 11. The tubular deviceof claim 9 wherein the abrasive surface on the tip comprises crystallinealuminum oxide pieces permanently secured to said tip.
 12. A method oftreating the skin surface of a patient to remove surface cells andreduce undesirable skin blemishes comprising: providing amicrodermabrasion device comprising a tubular treatment tool with arotatable abrasive skin contacting surface within an open distal end ofa lumen of the treatment tool, providing a multiple RPM rotationaldrive, providing a pressure through the lumen within the tubulartreatment tool, the pressure being less than ambient pressuresurrounding the treatment tube, bringing the rotatable abrasive skincontacting surface into contact with the skin surface to be treatedwhile said lesser pressure is delivered to the skin surface through thelumen and moving the abrasive skin contacting surface across the skinsurface wherein while the rotatable abrasive skin contacting surface isa motor driven abrasive disk located within the lumen of the treatmenttool and adjacent the open distal end is rotated by the rotationaldrive, said vacuum providing increased contact between the skin surfaceand the abrasive disk.
 13. The method of claim 12 wherein the abrasiveskin contacting surface has an abrasive crystalline material adheredthereto.
 14. The method of claim 13 wherein the abrasive skin contactingsurface is formed by a machining process.
 15. The method of claim 14wherein the abrasive crystalline material is diamond crystals.
 16. Themicrodermabrasion device of claim 1 further including a delivery conduitmounted on the tube for providing chemicals to enhance abrasion andliquids to reduce friction, or irrigate or cool the skin surface andremove material loosened from the skin surface.
 17. Themicrodermabrasion device of claim 9 further including a delivery tubemounted on the tubular device for providing chemicals to enhanceabrasion and liquids to reduce friction, or irrigate or cool the skinsurface and remove material loosened from the skin surface.
 18. Themethod of claim 12 further including providing through the tubulartreatment tool and to the skin surface chemicals to enhance abrasion andliquids to reduce friction, or irrigate or cool the skin surface andremove material loosened from the skin surface while the abrasive skincontacting surface is moved across the skin surface being treated.